Dear Editor,
Maj MP Cariappa has brought out certain interesting facts in his reply [1] to my letter [2]. However, the basic questions are:
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a.
Do the soldiers need iodised salt?
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b.
If No, why should we force them to consume it?
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c.
Will the adverse effects of this forced consumption of exces iodine be attributable to service?
The rigorous medical examination prior to recruiting, weeds out all those with iodine deficiency. Frequent turn over of troops to various parts of the country ensures that the idividual does not stay for long in “the area environmentally deficient in iodine” and be prone to iodine deficiency. Good balanced diet provided in the Armed Forces meets all nutritional requirement of iodine without supplementing through salt. Under such circumstances the chance of iodine deficiency in a healthy adult euthyroid soldier, if any, is negligible. This is substantiated by analysis of our hospital records (Table 1). Only 15 cases of thyroid related disorders (8 serving soldiers and 7 dependents) out of more than 8000 admissions were admitted in our hospital in 1999. Amongst servicemen 2 fresh cases and 3 old casees of hypothyroidism, 1 goiter and 1 adenoma were seen. Incidentally, our hospital caters to the troops, ex-servicemen and their families staying in sub-Himalayan iodine deficiency belt! Incidence of iodine deficiency amongst the troops from other places too is expected to be similarly low.
TABLE 1.
Number of cases of thyroid related disorders admitted in MH Bareilly in 199. (Total admission > 8000)
| Diagnosis | Servicemen | Ex-servicemen | Children | Other dependant | Total |
|---|---|---|---|---|---|
| Hyper thyroidism | 01 | 01 | — | — | 02 |
| Hypo thyroidism | 05 | — | 01 | 01 | 07 |
| Goiter | 01 | — | — | 04 | 05 |
| Adenoma | 01 | — | — | — | 01 |
| Total | 08 | 01 | 01 | 05 | 15 |
“Good of the greater many at the risk …” [1] does not apply in Armed Forces as the greater many are NOT at the risk of iodine deficiency.
Under such circumstances, the effects of forced consumption of excess iodine through iodised salt in a euthyroid adult is likely to be moe harmful than useful. This then becomes directly caused by and attributable to the service conditions.
The Govt of India is withdrawing the clause of compulsory iodination of salt. Preliminary notification to this effect has already been issued by the Govt of India [3]. Shouldn't the health planners in Armed Forces too realise this and prescribe iodised salt only for the people at risk? Views and commemnts of readers and concerned authorities are awaited.
References
- 1.Cariappa MP. Reply: Letters to editor. MJAFI. 2000;56:177–178. [Google Scholar]
- 2.Gokhale S. Iodised Salt and Armed Forces. MJAFI. 2000;56:177. doi: 10.1016/S0377-1237(17)30152-1. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 3.Salt Govt May withdraw Clause on Iodised News report. In: The Times of India. New Delhi edition. 13 May 2000;12